Clinical Interventions in Aging (Feb 2023)
The Effect and Possible Mechanism of Cardiac Rehabilitation in Partial Revascularization Performed on Multiple Coronary Artery Lesions
Abstract
Yang Gao,1,* Ling Yue,2,* Zhilin Miao,1 Fengrong Wang,3 Shuai Wang,3 Bo Luan,1 Wenjun Hao1 1Department of Cardiology, The People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, People’s Republic of China; 2Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China; 3Department of Cardiology, The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenjun Hao, Department of Cardiology, The People’s Hospital of Liaoning Province, NO. 33, Wenyi Road, Shenhe District, Shenyang, Liaoning Province, 110016, People’s Republic of China, Email [email protected]: To observe the effect of cardiac rehabilitation (CR) in patients with partial revascularization performed on multiple coronary artery lesions and explore its possible mechanism.Patients and Methods: A total of 400 patients with multiple coronary artery lesions were enrolled and randomly divided into a complete revascularization group and a CR group, with 200 cases in each group. Target lesion revascularization was performed radically in the complete revascularization group, while it was partially completed in the CR group, and postoperative CR was performed. All the patients were put under conventional treatment. Left ventricular end diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walking distance (6-MWD), quality-of-life scores, safety and levels of serum nitric oxide (NO), nitric oxide synthase (NOS), superoxide dismutase (SOD), and vascular endothelial growth factor (VEGF) were evaluated and compared between two groups before and after training.Results: There was no significant difference in LVEDD, LVEF, 6-MWD, quality-of-life scores, levels of serum NO, NOS, SOD, and VEGF between two groups before training (p> 0.05). 1 year later, compared with the complete revascularization group, the occurrence of major adverse events in the CR group declined (p> 0.05); the measurements of LVEDD decreased and LVEF increased (p> 0.05), 6-MWD increased significantly (p< 0.05), quality-of-life scores were higher (p< 0.05), the levels of serum NO, NOS, and SOD increased noticeably, and the levels of serum VEGF decreased significantly in the CR group (p< 0.05). There were significant differences within the same group, before and after training (p< 0.05).Conclusion: Cardiac rehabilitation training, not increase in the incidence of adverse events, is effective and safe after partial revascularization in patients with multiple coronary artery lesions, which has notable clinical advantages in promoting patients’ exercise endurance and quality-of-life by improving the nitric oxide synthase system and antioxidant system and reducing the level of VEGF.Keywords: multiple coronary artery lesions, cardiac rehabilitation, coronary revascularization, 6-MWD, quality-of-life, NO/NOS
